Rash in Meningococcal Disease

Fig 2: Meningococcal meningitis rash (courtesy of Wellcome Images)

Most patients with meningococcal septicaemia develop a rash. However, this will not always be a feature at initial presentation. The rash can range from scanty blanching macular or maculopapular lesions to a rapidly evolving haemorrhagic rash. The ‘text-book’ non-blanching rash may be a very late sign, and the underlying meningitis or septicaemia is often very advanced by the time this rash appears.

A generalised petechial rash or purpuric rash in any location, in an ill child, is strongly suggestive of meningococcal septicaemia and should prompt urgent treatment.